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Estimated glomerula...
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Damgaard, TobiasLinköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Linköping University, Sweden:Region Kalmar County, Sweden
(författare)
Estimated glomerular filtration rate as a tool for early identification of patients with insufficient exposure to beta-lactam antibiotics in intensive care units
- Artikel/kapitelEngelska2024
Förlag, utgivningsår, omfång ...
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2024
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Taylor & Francis Group,2024
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:lnu-128434
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https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-128434URI
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https://doi.org/10.1080/23744235.2024.2323002DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-201835URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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Funding Agencies|Region Kalmar County
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Background: Only about 50% of intensive care unit (ICU) patients reach a free trough concentration above MIC (100% fT > MIC) of beta-lactam antibiotics. Although dose adjustments based on therapeutic drug monitoring (TDM) could be beneficial, TDM is not widely available. We investigated serum creatinine-based estimated GFR (eGFR) as a rapid screening tool to identify ICU patients at risk of insufficient exposure. Method: Ninety-three adult patients admitted to four ICUs in southeast Sweden treated with piperacillin/tazobactam, meropenem, or cefotaxime were included. Beta-lactam trough concentrations were measured. The concentration target was set to 100% fT > MICECOFF (2, 4, and 16 mg/L based on calculated free levels for meropenem, cefotaxime, and piperacillin, respectively). eGFR was primarily determined via Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and compared to three other eGFR equations. Data was analysed using logistic regression and receiver operative characteristic (ROC) curves. Results: With intermittent standard dosing, insufficient exposure was common in patients with a relative eGFR >= 48mL/min/1.73m(2) [85%, (45/53)], particularly when treated with cefotaxime [96%, (24/25)]. This eGFR cut-off had a sensitivity of 92% and specificity of 82% (AUC 0.871, p < 0.001) in identifying insufficient exposure. In contrast, patients with eGFR <48mL/min/1.73m(2) had high target attainment [90%, (36/40)] with a wide variability in drug exposure. There was no difference between the four eGFR equations (AUC 0.866-0.872, cut-offs 44-51 ml/min/1.73m(2)). Conclusion: Serum creatinine-based eGFR is a simple and widely available surrogate marker with potential for early identification of ICU patients at risk of insufficient exposure to piperacillin, meropenem, and cefotaxime.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Woksepp, HannaLinnéuniversitetet,Institutionen för kemi och biomedicin (KOB),Region Kalmar County, Sweden,Linnaeus Univ, Sweden; Linnaeus Univ, Sweden; Linnaeus Univ, Sweden(Swepub:lnu)havoaa
(författare)
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Brudin, LarsLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Linköping University, Sweden; Region Kalmar County, Sweden(Swepub:liu)larbr27
(författare)
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Bonnedahl, JonasLinköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Linköping University, Sweden:Region Kalmar County, Sweden(Swepub:liu)jonbo68
(författare)
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Nielsen, Elisabet I.Uppsala University, Sweden,Uppsala Univ, Sweden
(författare)
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Schön, ThomasLinköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Klinisk mikrobiologi,Region Östergötland, Infektionskliniken i Östergötland,Linköping University, Sweden;Region Kalmar County, Sweden(Swepub:liu)thosc49
(författare)
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Hällgren, AnitaLinköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland,Linköping University, Sweden(Swepub:liu)aniha32
(författare)
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Linköpings universitetAvdelningen för inflammation och infektion
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Infectious Diseases: Taylor & Francis Group2374-42352374-4243
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